Prospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 16, 2024; 16(4): 206-213
Published online Apr 16, 2024. doi: 10.4253/wjge.v16.i4.206
In vivo pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging
Hai-Bin Dong, Tao Chen, Xiao-Fei Zhang, Yu-Tang Ren, Bo Jiang
Hai-Bin Dong, Tao Chen, Yu-Tang Ren, Bo Jiang, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
Xiao-Fei Zhang, Center for Medical Data Science, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
Co-first authors: Hai-Bin Dong and Tao Chen.
Co-corresponding authors: Yu-Tang Ren and Bo Jiang.
Author contributions: Zhang XF contributed to statistical analysis of data; Dong HB contributed to drafting of the article; Dong HB and Chen T contributed to analysis and interpretation of the data; Ren YT and Jiang B, as co-corresponding authors, played an important role in the design, progress and summary of the study. Ren YT found that the new endoscope could be used for the study of blood microcirculation, and personally completed all endoscopic operations and designed the analysis indicators. Jiang B introduced new endoscopes, controlled the whole research concept and design, critically revised important contents of the paper, and finally approved the paper.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Beijing Tsinghua Changgung Hospital (20002-0-02).
Clinical trial registration statement: This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000031294).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no grant support and conflicts of interest or financial ties to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Tang Ren, PhD, Doctor, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, No. 168 Litang Road, Changping District, Beijing 102218, China. ryta01044@btch.edu.cn
Received: December 28, 2023
Peer-review started: December 28, 2023
First decision: January 19, 2024
Revised: January 29, 2024
Accepted: March 18, 2024
Article in press: March 18, 2024
Published online: April 16, 2024
ARTICLE HIGHLIGHTS
Research background

Colorectal cancer (CRC) is one of the most common malignancies in humans. Prior research has shown that identifying premalignant stage lesions (adenomas) of CRC by colonoscopy and subsequent endoscopic resection can prevent disease progression and reduce CRC-associated morbidity and mortality. Angiogenesis, the secondary growth of blood vessels, plays an important role in the development of tumors. The surface capillaries of colorectal tumors often show morphological changes, such as heterogeneity in vessel diameter or density and loss of hierarchical structure.

Research motivation

Although the importance of tumor angiogenesis is well known, conventional endoscopic images cannot be used to show these changes in capillaries due to inadequate resolution. No studies have yet been conducted on changes in microcirculatory hemodynamics of colorectal adenomas in vivo under endoscopy. In clinical practice, we found that a novel high-resolution magnifying colonoscope (Fujifilm EC-760ZP) with blue-laser imaging (BLI) clearly revealed the mucosal surface capillary network in vivo and in real time.

Research objectives

In this study, we observed the superficial microcirculation of colorectal adenomas using the novel magnifying colonoscope with BLI and quantitatively analyzed the changes in hemodynamic parameters, thus providing a new insight into early colorectal tumors.

Research methods

From October 2019 to January 2020, 11 patients were screened for colon adenomas with the novel high-resolution magnification endoscope with BLI. Video images were recorded and processed with Adobe Premiere, Adobe Photoshop and Image-pro Plus software. Four microcirculation parameters: Microcirculation vessel density, mean vessel width with width standard deviation, and blood flow velocity, were calculated respectively for adenoma and the surrounding normal mucosa.

Research results

A total of 16 adenomas were identified. Compared with the normal surrounding mucosa, the superficial vessel density in the adenomas was decreased; the mean vessel width and vessel width deviation were both increased; and blood flow slowed down in the adenomas.

Research conclusions

The novel high-resolution magnification endoscope with BLI can be a tool for the in vivo study of adenoma superficial microcirculation. The superficial vessel density in the adenoma was decreased, with more irregularity and slower blood flow.

Research perspectives

High-resolution magnifying endoscopy can be used to quantitatively analyze the microcirculation on the surface of the colorectal adenomas. It provide the possibility of active recognition of colorectal lesions with AI technology under endoscopy.